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Trial registered on ANZCTR
Registration number
ACTRN12605000285651
Ethics application status
Approved
Date submitted
10/08/2005
Date registered
5/09/2005
Date last updated
19/11/2019
Date data sharing statement initially provided
19/11/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
The AustraliaN Trial Investigating Post Operative Deficit, Early extubation and Survival (ANTIPODES)
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Scientific title
The prospective randomised controlled ANTIPODES Trial will test whether early extubation following coronary artery graft surgery (CAGS) and the perioperative anaesthetic management that permits early extubation, results in a significant reduction in postoperative cognitive dysfunction in the short and medium term.
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Secondary ID [1]
260030
0
nil
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Universal Trial Number (UTN)
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Trial acronym
The ANTIPODES Trial
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Post Operative Cognitive Dysfunction (POCD)
373
0
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Condition category
Condition code
Surgery
440
440
0
0
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Other surgery
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Anaesthesiology
441
441
0
0
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Anaesthetics
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Mental Health
442
442
0
0
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Studies of normal psychology, cognitive function and behaviour
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
To test whether early extubation following CAGS results in a significant reduction in the incidence of POCD. Low dose anaesthesia permitting early extubation will consist of routine clinical practice using fentanyl 10 micrograms/kg, propofol as required. High dose fentanyl anaesthesia will consist of routine clinical practice using fentanyl 50 micrograms/kg, propofol as required. Patients will complete a battery of neuropsychological tests preoperatively, and 6 days, 3 months and 12 months postoperatively. Quality of life and depression will be assessed preoperatively and at 3 months and 12 months postoperatively.
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Intervention code [1]
159
0
Treatment: Other
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Comparator / control treatment
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Control group
Dose comparison
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Outcomes
Primary outcome [1]
500
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Frequency of POCD
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Assessment method [1]
500
0
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Timepoint [1]
500
0
12 months post surgery
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Secondary outcome [1]
1081
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Length of time in ICU
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Assessment method [1]
1081
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Timepoint [1]
1081
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Primary outcome is POCD at 12 months post surgery, secondary outcomes to identify predictors. Length of time in ICU will be assessed via accessing patient records through the hospital's internal system. Specifically the patient's ICU discharge summary will be consulted, as well as their bed transfer information.
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Secondary outcome [2]
1082
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Length of stay in hospital
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Assessment method [2]
1082
0
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Timepoint [2]
1082
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Primary outcome is POCD at 12 months post surgery, secondary outcomes to identify predictors. Length of stay in hospital will be assessed via accessing patient records through the hospital's internal system.
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Secondary outcome [3]
1083
0
Cumulative incidence of death and complications.
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Assessment method [3]
1083
0
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Timepoint [3]
1083
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Primary outcome is POCD at 12 months post surgery, secondary outcomes to identify predictors. Incidence of death and complications will be assessed via accessing patient records through the hospital's internal system.
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Eligibility
Key inclusion criteria
Scheduled for first time coronary artery bypass surgery, who give written informed consent. Patients must be suitable for neuropsychological testing and without neurological deficit.
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Minimum age
55
Years
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Maximum age
Not stated
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Poor left ventricular function (ejection fraction < 30%); 2. major systemic illness contraindicating early extubation (eg. chronic respiratory impairment); 3. pre-existing neurological disease (eg. stroke); 4. anticipated difficulty with neuropsychological assessment such as English not being the prime language.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sealed envelope allocated to each patient and distributed to anaesthetist immediately prior to surgery.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Generated from a table of random numbers. The restriction method will be random permuted blocks. Sequence will be stratified for hospital (site) and off-pump/om-pump.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
Safety
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
18/04/2001
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Actual
17/04/2001
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Date of last participant enrolment
Anticipated
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Actual
10/12/2003
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Date of last data collection
Anticipated
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Actual
27/11/2004
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Sample size
Target
350
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Accrual to date
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Final
349
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
493
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Government body
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Name [1]
493
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National Health and Medical Research Council
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Address [1]
493
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National Health and Medical Research Council
GPO Box 1421
Canberra ACT 2601
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Country [1]
493
0
Australia
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Funding source category [2]
264915
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Other Collaborative groups
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Name [2]
264915
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Australian and New Zealand College of Anaesthetists (ANZCA)
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Address [2]
264915
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St Kilda Road, Melbourne
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Country [2]
264915
0
Australia
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Primary sponsor type
Individual
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Name
Dr. Brendan Silbert
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Address
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Country
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Secondary sponsor category [1]
395
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Individual
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Name [1]
395
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A/Prof. David Scott
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Address [1]
395
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Department of Anaesthesia, St. Vincent's Hospital, PO Box 2900, Fitzroy 3065
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Country [1]
395
0
Australia
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Secondary sponsor category [2]
396
0
Individual
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Name [2]
396
0
A/Prof. Paul Maruff
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Address [2]
396
0
Neurosciences Department, University of Melbourne, Parkville, Victoria
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Country [2]
396
0
Australia
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Secondary sponsor category [3]
397
0
Individual
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Name [3]
397
0
A/Prof Paul Myles
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Address [3]
397
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Department of Anaesthesia and Pain Management, Alfred Hospital, Commercial Road, Prahran
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Country [3]
397
0
Australia
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Secondary sponsor category [4]
398
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Individual
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Name [4]
398
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A/Prof Konrad Jamrozik
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Address [4]
398
0
c/o St. Vincent's Hospital, PO Box 2900, Fitzroy 3065
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Country [4]
398
0
Australia
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Secondary sponsor category [5]
399
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Individual
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Name [5]
399
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Ms. Lis Evered
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Address [5]
399
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Department of Anaesthesia, St. Vincent's Hospital, PO Box 2900, Fitzroy 3065
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Country [5]
399
0
Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
1468
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St. Vincent's Hospital Melbourne
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Ethics committee address [1]
1468
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PO Box 2900 Fitzroy 3065
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Ethics committee country [1]
1468
0
Australia
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Date submitted for ethics approval [1]
1468
0
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Approval date [1]
1468
0
01/01/2001
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Ethics approval number [1]
1468
0
004/01
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Ethics committee name [2]
1469
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St. Vincent's Private Hospital
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Ethics committee address [2]
1469
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Melbourne
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Ethics committee country [2]
1469
0
Australia
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Date submitted for ethics approval [2]
1469
0
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Approval date [2]
1469
0
01/06/2001
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Ethics approval number [2]
1469
0
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Ethics committee name [3]
1470
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Alfred Hospital
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Ethics committee address [3]
1470
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Melbourne
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Ethics committee country [3]
1470
0
Australia
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Date submitted for ethics approval [3]
1470
0
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Approval date [3]
1470
0
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Ethics approval number [3]
1470
0
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Summary
Brief summary
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Trial website
www.cognition.org.au
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Trial related presentations / publications
1) Silbert BS, Maruff P, Evered LA, Scott DA, Kalpokas M, Martin KJ, et al. Detection of cognitive decline after coronary surgery: a comparison of computerized and conventional tests. Br J Anaesth 2004;92(6):814-20 2) Lewis MS, Maruff P, Silbert BS, Evered LA, Scott DA. The influence of different error estimates in the detection of post-operative cognitive dysfunction using reliable change indices with correction for practice effects. Arch Clin Neuropsychol 2006;21(5):421-7 3) Lewis MS, Maruff P, Silbert BS, Evered LA, Scott DA. Detection of postoperative cognitive decline after coronary artery bypass graft surgery is affected by the number of neuropsychological tests in the assessment battery. Ann Thorac Surg 2006;81(6):2097-104 4) Lewis MS, Maruff P, Silbert BS, Evered LA, Scott DA. The sensitivity and specificity of three common statistical rules for the classification of post-operative cognitive dysfunction following coronary artery bypass graft surgery. Acta Anaesthesiol Scand 2006;50(1):50-7 5) Silbert BS, Scott DA, Evered LA, Lewis MS, Kalpokas M, Maruff P, et al. A comparison of the effect of high- and low-dose fentanyl on the incidence of postoperative cognitive dysfunction after coronary artery bypass surgery in the elderly. Anesthesiology 2006;104(6):1137-45 6) Silbert B, Scott D, Evered L, Lewis M, Maruff P. Pre-existing cognitive impairment in patients for elective coronary artery bypass graft surgery. Anesth and Analg 2007;104(5):1023-8 7) Silbert, B., Evered, L., Scott, D., McCutcheon, C., Jamrozik, K. Homocysteine and c-reactive protein are not markers of cognitive impairment in patients with major cardiovascular disease. Dement Geriatr Cogn Disord 2008;25(4): 309-16 8) Silbert, B. S., L. A. Evered, et al. The apolipoprotein E epsilon4 allele is not associated with cognitive dysfunction in cardiac surgery. Ann Thorac Surg 2008;86(3): 841-7 9) Evered, L.A., Silbert, B., Scott,D.A., Maruff,P., Laughton,K.M., Volitakis,I., Cowie,T., Cherny,R.A., Masters,C.L., Li,Q-X. Plasma Aß42 and Aß40 Levels Predict Early Cognitive Dysfunction after Cardiac Surgery - Ann Thorac Surg 2009;88:1426-32 10) Evered, L.A., Silbert,B.S., Scott,D.A. Postoperative Cognitive Dysfunction and Aortic Atheroma. Ann Thorac Surg 2010;89:1091-7 11) Evered LA, Scott DA, Silbert BS, Maruff P. Post Operative Cognitive Dysfunction is Independent of Type of Surgery and Anesthetic. Anesth and Analg 2011;112(5):1179-85 12) Evered LA; Silbert B; Scott DA; Maruff P; Ames DA. A prospective study of the prevalence of dementia 7.5 years following coronary artery bypass graft surgery. Anesthesiology 2016; 125:62-71
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Public notes
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Contacts
Principal investigator
Name
35724
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Address
35724
0
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Country
35724
0
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Phone
35724
0
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Fax
35724
0
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Email
35724
0
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Contact person for public queries
Name
9348
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Dr. Brendan Silbert
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Address
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Department of Anaesthesia
St. Vincent's Hospital
PO Box 2900
Fitzroy VIC 3065
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Country
9348
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Australia
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Phone
9348
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+61 3 92884253
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Fax
9348
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+61 3 92884255
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Email
9348
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[email protected]
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Contact person for scientific queries
Name
276
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Ms. Lis Evered
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Address
276
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Department of Anaesthesia
St. Vincent's Hospital
PO Box 2900
Fitzroy VIC 3065
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Country
276
0
Australia
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Phone
276
0
+61 3 92882251
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Fax
276
0
+61 3 92884255
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Email
276
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Prevalence of Dementia 7.5 Years after Coronary Artery Bypass Graft Surgery.
2016
https://dx.doi.org/10.1097/ALN.0000000000001143
N.B. These documents automatically identified may not have been verified by the study sponsor.
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